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  Citation statistics : Table of Contents
   2012| July-September  | Volume 6 | Issue 3  
    Online since December 7, 2017

 
 
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ORIGINAL ARTICLES
New onset diabetes after transplantation (NODAT): Analysis of pre-transplant risk factors in renal allograft recipients
Jai Prakash, Surendra Singh Rathore, Takhellambam Brojen Singh, Tauhidul Alam Choudhury, Prabhakar , Usha
July-September 2012, 6(3):77-82
DOI:10.1016/j.ijt.2012.07.003  
Background: Occurrence of new onset diabetes after transplant (NODAT) has major impact on patient and graft survival, and cardiovascular mortality. Methods: In this retrospective study, among all renal transplant recipients who followed-up at our center during the period of January 1998 to April 2012, the development of NODAT was assessed by reviewing case records. Characteristics of patients with NODAT were compared with the patients who did not develop post-transplant diabetes. Results: Total 68 non-diabetic renal transplant recipients were included in analysis. Emergence of NODAT was observed in 13 (19.12%) recipients, with mean duration of onset at 52.73 ± 49.57 months post-transplant. Development of NODAT was significantly associated with; age of ≥45 years at transplant time (P 0.029, odds ratio 4.38), pre-transplant weight (P 0.031), presence of ADPKD (P 0.020, odds ratio 16.20), positive family history of diabetes (P 0.009, odds ratio 5.96), pre-transplant hypercholesterolemia (P 0.029, odds ratio 4.38), and pre-transplant hypertriglyceridemia (P 0.023, odds ratio 5.03). Risk of development of diabetes was not related to type of calcineurin inhibitor used. Conclusion: NODAT is common in our renal transplant patients. Risk of development of post-transplant diabetes was more closely related to traditional risk factors and was not influenced by immunosuppressive therapy.
[ABSTRACT]   Full text not available  [PDF] [CITATIONS]
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REVIEW ARTICLES
Nanocomposite: An emerging tool for bone tissue transplantation and drug delivery
Komal Taneja, Ashutosh Pareek, Pallavi Verma, Vivek Jain, Yashumati Ratan, Mahendra Singh Ashawat
July-September 2012, 6(3):88-96
DOI:10.1016/j.ijt.2012.07.002  
Current scenarios in bone and tissue transplantation with controlled drug delivery is quite challenging since historic methods of bone grafting, including the allogenic and autogenous grafts pose the disadvantages of high infection risks and sometimes shortage of donors. Even, the synthetic bone grafting materials show the disadvantage of differing from natural bone either in structure or composition. Therefore, nanocomposites have been developed as promising bone grafts particularly hydroxyapatite/collagen system. The role of nanocomposites in drug delivery using injectable cell scaffolds has also been overviewed. Moreover, the use of silica-based bioactive ceramics for bone tissue has also been stated. And the development of tissue engineering for the production of nanocomposites is also highlighted. Tissue engineering can be viewed as a special case of drug delivery, the goal here being the accomplishment of controlled delivery of mammalian cells. This review is focused with a sight to provide information regarding potential of nanocomposites as a promising and invaluable tool in the future growth and development of bone grafting as well as drug delivery carrier.
[ABSTRACT]   Full text not available  [PDF] [CITATIONS]
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CASE REPORTS
Passenger lymphocyte syndrome exhibited in a renal transplant recipient: A case report
Abhilash Chandra, Sudeendra S Gupta, RK Sharma, Anupama Kaul, Dharmendra Bhadauria, Narayan Prasad, Amit Gupta, Preeti Elhence, Atul Sonkar, Hem Chandra
July-September 2012, 6(3):97-99
DOI:10.1016/j.ijt.2012.08.003  
Passenger lymphocyte syndrome is an important though rare cause of immune hemolysis, an adverse effect affecting solid organ transplantation. Passenger lymphocytes in grafted kidney have been reported to result in autoimmune hemolytic anemia (AIHA) in minor ABO incompatible transplants. This case report describes one such case of a 26-year-old male renal allograft recipient of an ABO compatible renal transplant with his wife as a donor.
[ABSTRACT]   Full text not available  [PDF]
  - 40 6
Nonsurgical management of hematuria following percutaneous biopsy of renal allograft
Hira Lal, Kamlesh Jobanputra, Abhishek Chauhan, Anupama Kaul, RK Sharma, Dharmendra Bhadauria, Narayan Prasad
July-September 2012, 6(3):100-102
DOI:10.1016/j.ijt.2012.07.001  
With the increase in the number of percutaneous procedures performed, there is also associated increase in the number of complications. Although percutaneous renal allograft biopsy is gold standard to evaluate graft dysfunction, it is not without complications. Pseudoaneurysms, arteriovenous and arteriocalyceal fistulae are very rare but sometimes it may become life threatening requiring urgent intervention. Here, we report a case of nonsurgical management of massive hematuria following percutaneous biopsy of renal allograft.
[ABSTRACT]   Full text not available  [PDF]
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ORIGINAL ARTICLES
Urological and vascular complications in 720 renal transplantations – Lessons learned
YP S. Rana, DV Singh, SK Gupta, AA Pradhan, R Talwar, S Harkar, YK Swami
July-September 2012, 6(3):73-76
DOI:10.1016/j.ijt.2012.08.001  
Introduction: Kidney transplants have become common surgical procedures, with thousands performed yearly around the world. Surgical complications in renal transplantation result in significant morbidity to the recipient, with risk of graft loss and mortality. Material and methods: We retrospectively analyzed 720 cases of renal transplantation done at our center from 1991 to July 2010. The standard techniques of vascular anastomosis and extravesical stented ureteroneocystostomy were used. Results: Mean age at the time of transplantation was 33 years (range 5–67 years) and majority were male (558/720). Live related donor renal transplantation was performed in 684 and deceased donor kidney transplantation in 36 patients. The incidence of ureter related major complication was urinary leak in seven (0.97%) cases and intrinsic ureteral obstruction in two (0.27%) cases. Vascular complications occurred in nine cases including four cases of venous thrombosis of which two could be salvaged. Four grafts were lost due to arterial thrombosis and one due to arterial anastomotic dehiscence. Conclusion: Routine use of ureteric stent seems to reduce the rate of urinary complications. Meticulous tying of all lymphatics tends to reduce the incidence of obstructing lymphocele. Early diagnosis and prompt surgical treatment of urological and vascular complications helps in salvaging the grafts.
[ABSTRACT]   Full text not available  [PDF]
  - 52 12
REVIEW ARTICLES
Experiences regarding intervention in renal transplantations by nephrologists
Kalpesh Gohel, Mohan Rajapurkar
July-September 2012, 6(3):83-87
DOI:10.1016/j.ijt.2012.08.002  
Vascular complications after kidney transplantation occur at a rate of 1–4% cases. The commonest of these complications is graft artery stenosis. It is often detected following difficult to control hypertension and/or graft dysfunction. If detected early usually with the help of duplex Doppler ultrasonography it can be successfully treated by endovascular intervention by suitably trained specialists. Interventions are also needed for post graft biopsy hemorrhage or arterio-venous fistula (AVF). Percutaneous transcatheter fibrated platinum coil embolization super selectively in the artery supplying the AVF can be life saving. It may improve blood pressure control and graft function in selected cases. Other endovascular interventions performed in transplanted kidneys are graft renal angioplasty with or without stenting and placement of covered stent graft. Technological advances in noninvasive imaging like CT angiogram, contrast enhanced Doppler ultrasound and MR angiography have simplified diagnosis and follow up of these patients without compromising safety. At our institute since January 2007, we encountered 8 cases of transplant renal artery stenosis, 6 arteriovenous fistulas and a case of extra and intrarenal pseudo aneurysm. All patients with transplant renal artery stenosis underwent angioplasty and stenting successfully both in terms of anatomical correction and improvement in blood pressure control as well as graft function. One patient had arterial stenosis and arteriovenous fistulas both and he underwent simultaneous stenting and coil embolization. Three patients with fistulas who had significant bleeding underwent successful coil embolization while 2 patients who were asymptomatic are under close surveillance. One patient each who had extra and intrarenal pseudo aneurysm underwent successful endovascular covered stent grafting and multiple coil embolization respectively. Vascular interventions in renal allograft by experienced nephrology unit can achieve good success with minimal complications.
[ABSTRACT]   Full text not available  [PDF]
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